What is the normal resting blood pressure for a 5-year-old child while asleep and supine?

Normal Blood Pressure Values for a 5-Year-Old Child While Asleep and Supine

For a 5-year-old child, the normal resting blood pressure while asleep and in the supine position is approximately 98-99 mmHg systolic and 56 mmHg diastolic (50th percentile values). 1

Blood Pressure Measurement in Young Children

• Ambulatory blood pressure monitoring (ABPM) is the gold standard for assessing blood pressure patterns during sleep in children 2
• For accurate measurement in young children, appropriate cuff size is crucial - the bladder should encircle 80-100% of the limb circumference 1
• Monitors should be applied to the non-dominant arm unless contraindicated 2
• When measuring blood pressure during sleep, devices should be programmed to record BP every 20 to 30 minutes 2

Normal Blood Pressure Values During Sleep

• The 50th percentile for nighttime systolic blood pressure in young children is 98-99 mmHg 1
• The 50th percentile for nighttime diastolic blood pressure in young children is 56 mmHg 1
• The 95th percentile (upper limit of normal) for nighttime systolic blood pressure is 112-113 mmHg 1
• The 95th percentile for nighttime diastolic blood pressure is 66 mmHg 1

Factors Affecting Blood Pressure During Sleep

• Blood pressure naturally decreases during sleep compared to daytime values, a phenomenon known as "dipping" 2, 3
• The mean nocturnal systolic blood pressure is typically 13% ± 6% lower than daytime means 4
• The mean nocturnal diastolic blood pressure is typically 23% ± 9% lower than daytime means 4
• Position affects blood pressure readings - measurements tend to be lower in the prone position compared to supine position 5

Interpretation Considerations

• The first blood pressure measurement is often higher than subsequent measurements due to the startle response, with an average difference of 3 mmHg 5
• Multiple readings should be averaged for greater accuracy - at least three measurements are recommended 1, 5
• Reference values for ambulatory blood pressure in children are primarily based on European populations, which may limit generalizability to other ethnic groups 2
• There is a critical need for expanded normative data for pediatric ABPM, particularly for ambulatory diastolic blood pressure values 2

Clinical Significance

• Understanding normal sleep blood pressure values is important for accurate diagnosis of hypertension in children 2
• Persistently elevated blood pressure readings, even during sleep, may indicate underlying medical conditions that require further evaluation 6
• Blood pressure measurements obtained after ensuring a restful state are more representative of true resting blood pressures in children 5